肥胖对全身麻醉手术患儿罗库溴铵 药效动力学指标的影响研究

Effect of obesity on pharmacodynamics of Rocuronium in children

摘要:

目的 研究肥胖对全身麻醉手术患儿罗库溴铵药效动力学指标的影响研究。方法 选取2014 年12 月—2015 年12 月南京医科大学附属儿童医院进行手术治疗的96 例患儿，按体重指数（BMI）分为肥胖组（A 组， BMI ≥ 95％）、正常组（B 组，BMI 50％～ 95％）及低体重组（C 组，BMI ≤ 50％），每组32 例。3 组注入巴比 妥钠建立静脉通道后，进行诱导麻醉，5 s 内推注罗库溴铵。记录患儿苏醒指标（首次自主恢复指数、第1 次 不自主体动时间及首次睁眼时间）、肌松监测指标起效时间、无反应期及恢复指数，观察其不良反应情况。结 果 3 组3 项苏醒指标和恢复指数比较，差异无统计学意义（P >0.05）；A 组起效时间最短（P <0.05），C 组无 反应期最短、肌松药用量最少（P <0.05）；3 组均无不良反应发生，恢复良好。结论 肥胖症能加快全身麻醉手 术患儿罗库溴铵的药物起效时间、延长作用时间，是影响肌松药药效的重要因素之一；在治疗过程中应注意对 患儿体重指标的监测，进行个体化治疗。

Abstract:

Objective To study the effects of obesity on pharmacodynamics of Rocuronium in children undergoing general anesthesia. Methods A total of 96 children who underwent surgical treatment in Children's Hospital of Nanjing Medical University from December 2014 to December 2015 were enrolled and divided into obese group (A group, BMI ≥ 95%), normal group (group B, BMI between 50%-95%), and low body weight group (group C, BMI ≤ 50%) (n = 32). All children were injected with sodium Pentobarbital before establishing the intravenous channels. During induction, Rocuronium was injected in 5 seconds. First time of automatic recovery, recovery time of spontaneous involuntary body movement, first time of eye opening and onset, no response period, and recovery time were recorded. Adverse reactions were also monitored. Results No significant differences in three recovery monitoring indexes and recovery index in three groups were observed (P > 0.05). Time of onset in group A was the lowest (P < 0.05), while no response period and doses of muscle relaxant were the lowest in group C among three groups (P < 0.05). No obvious adverse reaction was recorded. Conclusion Obesity accelerates the onset time and prolongs the absence of response time of Rocuronium in children undergoing operation.